The Association between Heme Oxygenase-1 Gene Promoter Polymorphism and the Outcomes of Catheter Ablation of Atrial Fibrillation

Abstract

A length polymorphism of GT repeats in the promoter region of the human heme oxygenase-1 (HO-1) gene modulates its gene transcription to protect against myocardial injury. The present study investigated the association between HO-1 promoter polymorphisms and the outcomes of catheter ablation of atrial fibrillation (AF). The allelic frequencies of GT repeats in the HO-1 gene promoter were screened in 205 random individuals who underwent catheter ablation for drug refractory AF.In the patients who received catheter ablation, those with AF recurrence had fewer GT repeats (53.4±7.1 vs. 56.1±6.5, p = 0.004), a lower incidence of hyperlipidemia, more non-paroxysmal AF, and a larger left atrial diameter. After conducting a multivariate logistic analysis, the number of GT repeats (Odds ratio: 0.94, 95% CI 0.90–0.99, p = 0.01) and the diameter of the left atrium (Odds ratio: 1.08, 95% CI 1.02–1.15, p = 0.01) remained independent predictors. The carriers of GT repeats, which were <29 in both alleles, were associated with a lower sinus maintenance rate after catheter ablation (38.5% vs. 60.1%, p = 0.003). The patients were divided into paroxysmal and non-paroxysmal AF groups; the number of GT repeats was associated with AF recurrence only in the patients with paroxysmal AF. The number of GT repeats, combined with LAD, was significant for predicting AF recurrence after catheter ablation (p = 0.01). The number of GT repeats was not found to be associated with differences in the left atrial diameter, the biatrial voltage, or the levels of bilirubin, ferritin, iron, C-reactive protein, or von-Willibrand factor. In conclusions, HO-1 gene promoter polymorphisms were associated with AF recurrence after catheter ablation.

Good responders to catheter ablation for long-standing persistent atrial fibrillation: Clinical and genetic characteristics

“…Over the last few years, several common genetic variants have been demonstrated to be associated with AF in GWAS performed in European ancestry [14] and the Chinese Han GeneID cohort [13]. Some reports have suggested that these genetic polymorphisms are associated with an increased risk of AF recurrence after RFCA [6][7][8][9]24]. However, there are ethnic differences in the frequency of these SNPs and their association with clinical phenotypes [10,13].…”

“…Therefore, we sought to identify patient factors predicting favorable success rates, and hypothesized that better patient selection criteria may improve clinical outcomes, reduce unnecessary cardiac tissue damage, or avoid unnecessary ablation procedures and reduce medical costs and procedure-related complications. Recently, there were several reports for the relationship between genetic polymorphism and clinical outcome of AF ablation [6][7][8][9]. Although there are significant ethnic differences [10], genetic polymorphism can be utilized as an innate biomarker to identify good responders for AF catheter ablation.…”

Genetic ACE I/D Polymorphism and Recurrence of Atrial Fibrillation After Catheter Ablation

“…6,7 However, there is only limited data correlating genotypes with outcomes of AF therapies [8][9][10] and in particular with rhythm outcome after AF ablation. [11][12][13] Consequently, this study tested the hypothesis that the angiotensin-converting enzyme gene (ACE) insertion/deletion polymorphism associates with AF recurrence after catheter ablation. Using a candidate gene approach, this polymorphism was selected because the ACE deletion allele, ACE D, is associated with increased ACE serum levels, higher cardiac ACE activity, and increased cardiac fibrosis.…”

Association of SCN10A Polymorphisms with the Recurrence of Atrial Fibrillation after Catheter Ablation in a Chinese Han Population

“…It has also been previously shown that some genetic factors predict the risk of AF recurrence after catheter ablation181920212223. Recently, Husser et al 18.…”